aVR导联T波直立:心尖肥厚的心电图特征

Positive T-wave in Lead aVR: a Electrocardiographic Finding of Apical Hypertrophy

目的胸前导联T波倒置与左室高电压为心尖肥厚最常见的心电图表现,我们预测aVR导联T波直立为心尖肥厚的另一重要心电图特征。方法回顾分析63例左室肥厚患者的临床资料,根据是否存在心尖肥厚分为心尖肥厚组(n=24,13例单纯心尖肥厚,11例混合性心肌肥厚)和非心尖肥厚组(n=39,19例单纯室间隔肥厚,20例多部位心肌肥厚)。分析比较两组患者的心电图与超声心动图特点。结果结果显示,相比较于非心尖肥厚组,aVR导联T波直立与胸前导联T波倒置更多见于心尖肥厚组。aVR导联T波直立在两组间的比例为83.3%vs.30.8%(P<0.0001),胸前导联T波倒置为83.3%vs.59.0%(P=0.004)。结论研究表明,aVR导联T波直立与胸前导联T波倒置为心尖肥厚的重要心电图表现,可提高心尖肥厚的诊断。

Objecitve T-wave inversions in the precordial leads and high left ventricular voltage are the most frequent electrocardiographic findings in patients with apical hypertrophy.We hypothesized that the positive T-wave in lead aVR is an effective electrocardiographic method to detect apical hypertrophy.Methods We performed a retrospective review of 63 patients with left ventricular hypertrophy.According to whether or not the apex is involved,apical hypertrophy group(n=24,13 pure apical hypertrophy and 11 mixed)and non-apical hypertrophy group(n=39,19 pure ventricular septal hypertrophy and 20 multiple site hypertrophy)were included.Electrocardiographic and echocardiographic data was compared between the two groups.Results The results show that positive T-wave in lead aVR and T-wave inversions in the precordial leads were seen more common in apical hypertrophy group compared with those without apical hypertrophy(83.3%vs.30.8%for positive T-wave in lead aVR,P<0.0001;and 83.3%vs.59.0%for T-wave inversions in the precordial leads,P=0.004).Conclusion The study indicates that positive T-wave in lead aVR and T-wave inversions in the precordial leads are significant ECG features of apical hypertrophy.These two indexes may help us to improve the diagnostic value of apical hypertrophy.